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Pediatrics > PICU > Flashcards

PICU Flashcards

1
Q

At what pressure does the pop off valve come off a self-inflating bag?

A

40-45mmHg

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2
Q

What is the first type of drugs to be used in a planned intubation?

A

vagolytics- atropine of glycopyrollate as the mechanical pressures of intubation/laryngoscopy causes a vagal response and bradycardia. You can give these drugs to stop that.

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3
Q

Thiopental

A

Pentathal, barbituate; Very fast time of onset /offset 5-10min. Primary effect is sedation. Good to control increased ICP. Bad for hemodynamics. 2-4mg/kg. No amnesia or analgesia

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4
Q

Ketamine

A

Sedation, amnesia, and analgesia. Not good for ICP, good for hemodynamics, good for RAD b/c bronchodilator. Causes release of catecholines and maintain bp. 1-3mg/kg. Can give IM. Can get bad dreams (can add versed). Causes increased secretions

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5
Q

Benzo and narcotic combo

A

Most common versed and fentanyl. Sedate without losing bp or protective airway. Cause amnesia and analgesia and sedation. Lasts for 30-45 min.

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6
Q

Dose of versed and fentanyl for procedures

A

0.1mg/kg versed. 2-4ug/kg fentanyl

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7
Q

Propofol

A

Onset 60s, offset 5-10min. Good for ICP, bad for hemodynamics. Feel great after waking up.

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8
Q

Etomidate

A

Best for hemodynamic instability. 0.2mg/kg. Can cause clonic activity. Can get adrenal suppression. Not recommended for kids with septic shock.

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9
Q

Lidocaine

A

Good for control of RAD and ICP. Optional adjunct

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10
Q

Succinylcholine

A

Depolarizing muscle relaxant. Antagonist to postsynaptic Ach receptors, but causes muscle twitch. duration 5-10minutes. Can cause potassium to go up. Contraindic: hyperkalemia, congenital myopathy, burns, trauma, spinal cord trauma. Advantage: very potent, very fast 60s onset, 5-10min offset. Emergency drug

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11
Q

What are non-depolarizing agents

A

Pancuronium, Vecuronium, ciscuronium; onset 2-3 min, last 30-40 minutes. dependent on renal excretion. Contraindic: Renal failure

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12
Q

Pancuronium

A

vagolytic

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13
Q

Cisatricarium

A

Non steroidal. Hoffman degradation, not renal or hepatic excretion. 2-3min onset time, 20min offset. More expensive.

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14
Q

Rocuronium

A

Non-depolarizing, more hepatic than renal. Works quickly, 1-2 min onset, 20-40min offset.

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15
Q

What is the first type of drugs to be used in a planned intubation?

A

vagolytics- atropine of glycopyrollate as the mechanical pressures of intubation/laryngoscopy causes a vagal response and bradycardia. You can give these drugs to stop that.

How well did you know this?
1
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3
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16
Q

Thiopental

A

Pentathal, barbituate; Very fast time of onset /offset 5-10min. Primary effect is sedation. Good to control increased ICP. Bad for hemodynamics. 2-4mg/kg. No amnesia or analgesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Ketamine

A

Sedation, amnesia, and analgesia. Not good for ICP, good for hemodynamics, good for RAD b/c bronchodilator. Causes release of catecholines and maintain bp. 1-3mg/kg. Can give IM. Can get bad dreams (can add versed). Causes increased secretions

18
Q

Benzo and narcotic combo

A

Most common versed and fentanyl. Sedate without losing bp or protective airway. Cause amnesia and analgesia and sedation. Lasts for 30-45 min.

19
Q

Dose of versed and fentanyl for procedures

A

0.1mg/kg versed. 2-4ug/kg fentanyl

20
Q

Propofol

A

Onset 60s, offset 5-10min. Good for ICP, bad for hemodynamics. Feel great after waking up.

21
Q

Etomidate

A

Best for hemodynamic instability. 0.2mg/kg. Can cause clonic activity. Can get adrenal suppression. Not recommended for kids with septic shock.

22
Q

Lidocaine

A

Good for control of RAD and ICP. Optional adjunct

23
Q

Succinylcholine

A

Depolarizing muscle relaxant. Antagonist to postsynaptic Ach receptors, but causes muscle twitch. duration 5-10minutes. Can cause potassium to go up. Contraindic: hyperkalemia, congenital myopathy, burns, trauma, spinal cord trauma. Advantage: very potent, very fast 60s onset, 5-10min offset. Emergency drug

24
Q

What are non-depolarizing agents

A

Pancuronium, Vecuronium, ciscuronium; onset 2-3 min, last 30-40 minutes. dependent on renal excretion. Contraindic: Renal failure

25
Q

Pancuronium

A

vagolytic

26
Q

Cisatricarium

A

Non steroidal. Hoffman degradation, not renal or hepatic excretion. 2-3min onset time, 20min offset. More expensive.

27
Q

Rocuronium

A

Non-depolarizing, more hepatic than renal. Works quickly, 1-2 min onset, 20-40min offset.

28
Q

What type of pressures should you aim for when intubating an asthmatic?

A

tidal volume 5-6mL/kg, plateau pressure not above 35mmHg

29
Q

How do you decrease air trapping in asthmatic?

A
  1. Administer bronchodilator 2. increase expiratory time 3. Decrease tidal volume and minute ventilation
30
Q

Which sedatives are good for asthmatics?

A

isoflurane or ketamine

31
Q

How do you determin ET size?

A

Estimated size of inner diameter of uncuffed endotracheal tube (in mm) =
(Patient age in years / 4) + 4

32
Q

How do you determine the depth of ET tube?

A

age/2 +12

33
Q

What is dose of atropine in pediatric code?

A

0.02mg/kg

34
Q

What is dose of adenosine in pediatric code?

A

0.1mg/kg

35
Q

Amiodoarone dose in a code?

A

5mg/kg

36
Q

Initial defibrillation joules?

A

2J/kg

37
Q

repeat defibrillation joules?

A

4J/kg x2

38
Q

Defibrillation (cardioversion)

A

0.5-1J/kg

39
Q

Dose of epinephrine in codes

A

0.01mg/kg or 0.1ml/kg of 1:10,000 soln IV

40
Q

Dose of epi for anaphylaxis

A

0.01mg/kg of 1:1000 soln IM

41
Q

What dose of glucose bolus should be given for hypoglycemia?

A

2-4ml/kg of D25W over 20minut

42
Q

Does of Bicarc

A

1meq/kg

Pediatrics (25 decks)

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